Chemotherapy and hair loss: What to expect during treatment

You might not think about how important your hair is until you face losing it. And if you have cancer and are about to undergo chemotherapy, the chance of hair loss is very real. Both men and women report hair loss as one of the side effects they fear most after being diagnosed with cancer.

Whether you have hair loss from your chemotherapy depends mostly on the type and dose of medication you receive. But whether you can maintain a healthy body image after hair loss depends a lot on your attitude and the support of your friends and family.

Chemotherapy and hair loss: Why does it occur?

Chemotherapy drugs are powerful medications that attack rapidly growing cancer cells. Unfortunately, these drugs also attack other rapidly growing cells in your body — including those in your hair roots.

Chemotherapy may cause hair loss all over your body — not just on your scalp. Sometimes your eyelash, eyebrow, armpit, pubic and other body hair also falls out. Some chemotherapy drugs are more likely than others to cause hair loss, and different doses can cause anything from a mere thinning to complete baldness.

Talk to your doctor or nurse about the medication you'll be taking. Your doctor or nurse can tell you what to expect.

Fortunately, most of the time hair loss from chemotherapy is temporary. You can expect to regrow your hair three to six months after your treatment ends, though your hair may temporarily be a different shade or texture.

Chemotherapy and hair loss: What should you expect?

Hair usually begins falling out two to four weeks after you start treatment.

It could fall out very quickly in clumps or gradually. You'll likely notice accumulations of loose hair on your pillow, in your hairbrush or comb, or in your sink or shower drain. Your scalp may feel tender.

Your hair loss will continue throughout your treatment and up to a few weeks afterward. Whether your hair thins or you become completely bald will depend on your treatment.

People with cancer report hair loss as a distressing side effect of treatment. Each time you catch a glimpse of yourself in a mirror, your changed appearance is a reminder of your illness and everything you've experienced since your diagnosis.

It may take several weeks after treatment for your hair to recover and begin growing again. When your hair starts to grow back, it will probably be slightly different from the hair you lost. But the difference is usually temporary. Your new hair might have a different texture or color. It might be curlier than it was before, or it could be gray until the cells that control the pigment in your hair begin functioning again.

Chemotherapy and hair loss: Can hair loss be prevented?

No treatment exists that can guarantee your hair won't fall out during or after chemotherapy. The best way for you to deal with impending hair loss is to plan ahead and focus on making yourself comfortable with your appearance before, during and after your cancer treatment.

Several treatments have been investigated as possible ways to prevent hair loss, but none has been absolutely effective, including:

Scalp hypothermia (cryotherapy). During your chemotherapy infusions, ice packs or similar devices are placed on your head to slow blood flow to your scalp. This way, chemotherapy drugs are less likely to have an effect on your hair.

Studies of scalp hypothermia have found it works somewhat in the majority of people who have tried it. However, the procedure also causes a small risk of cancer recurring in your scalp, as this area doesn't receive the same dose of chemotherapy as the rest of your body. People undergoing scalp hypothermia report feeling uncomfortably cold and having headaches.

Minoxidil (Rogaine). Applying minoxidil — a drug approved for hair loss in men and women — to your scalp before and during chemotherapy isn't likely to prevent your hair loss, although some research shows it may speed up your hair regrowth. More research is needed to understand whether minoxidil is effective in regrowing hair after cancer treatment.

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